胰头癌胰十二指肠切除术中腹膜后神经、淋巴软组织廓清的临床及预后分析  

Clinical Significance of Retroperitoneum Nerves,Lymph Nodes and Soft Tissue Dissection in Pancreatectomy for Pancreatic Head Cancer

作　　者：邵钦树[1] 邵长明[2] 王元宇[1] 

机构地区：[1]浙江省人民医院普外科 [2]温州医学院

出　　处：《医学研究杂志》2011年第8期77-79,共3页Journal of Medical Research

基　　金：浙江省科技计划基金资助项目(2008C33018)

摘　　要：目的探讨胰头癌胰十二指肠切除术中腹膜后神经、淋巴软组织廓清的临床意义。方法回顾性分析了32例胰头癌胰十二指肠切除术中腹膜后神经、淋巴、软组织廓清的临床和病理及随访资料。结果所有胰头癌患者无手术相关性死亡,无术后出血、胆漏、胰漏及人工血管感染等严重并发症。神经浸润23例(71.88%),淋巴结阳性患者22例(68.75%)。患者1年、3年和5年生存率分别为71.88%(23/32)、43.75%(14/32)和15.63%(5/32)。神经浸润阴性和神经浸润阳性患者的生存率具有显著性差异(P<0.05)。淋巴结阴性和淋巴结阳性患者的生存率具有显著性差异(P<0.05)。结论胰头癌胰十二指肠切除术中腹膜后神经、淋巴软组织廓清可以有效地避免后腹膜切缘残留造成的复发,提高患者的远期生存率。Objective To investigation the clinical significance of retroperitoneum nerves,lymph nodes and soft tissue dissection in pancreatectomy for pancreatic head cancer. Methods Thirty - two cases of pancreatectomy with retroperitoneum nerves,lymph nodes and soft tissue dissection for pancreatic head cancer were retrospectively analyzed. Results All operations were successfully accomplished. There was no eomplication of hemorrhage bile leak, pancreatic leak and infection of artifical vessel. There were 23 cases with retroperitoneum nerves infiltration and 22 case with positive lymph nodes in retroperitoneum. The 1 - ,3 - and 5 - year cumulative survival rates were 71.88% （23/32） ,43.75% （14/32） and 15.63% （5/32） , respectively. The cumulative survival rates of patients with negative lymph nodes in retroperitoneum after radical resection were significantly higher than that of patients with positive lymph nodes in retroperitoneum （P 〈0. 05 ）. The cumulative survival rates of patients without retroperitoneum nerves infiltration after radical resection were significantly higher than that of patients with retroperitoneum nerves infiltration （P 〈 0.05）. Conclusion The radical pancreatoduodenectomy with ret- roperitoneum nerves,lymph nodes and soft tissue dissection could reduce the rate of tumor recurrence due to positive margins of retroperito- neum,and cure the patients with a longer survival time.

关 键 词：胰腺肿瘤 神经丛 淋巴结 预后 

分 类 号：R657.5[医药卫生—外科学]